| NPI | 1548558695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WV 1141) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KY 129215) |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2023-03-23 |