| NPI | 1477550291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: KY 1411) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KY 1141) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2007-07-08 |