| NPI | 1518390723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: KY PSYPPR00216468) |
| Additional Taxonomies | 171W00000X Contractor (Licence: KY KY-0554) |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2015-10-22 |