| NPI | 1457721631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 0941) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC1900X Psychologist, Counseling (Licence: KY ky941) | |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2015-12-18 |