| NPI | 1558308981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 1711) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 2004033740) |
| 1041C0700X Social Worker, Clinical (Licence: KY 3429) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2013-03-11 |