| NPI | 1538557673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 129941) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 1720) |
| 103TC0700X Psychologist, Clinical (Licence: LA 1133) | |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2016-05-26 |