| NPI | 1467643296 |
|---|---|
| Former Name | LISA M O'BRIEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: KY 130232) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: KY KY1351) |
| 103TC0700X Psychologist Clinical (Licence: KY 1531) | |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2022-03-02 |