| NPI | 1558907063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: KY 266149) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KY 266149) |
| 103TH0100X Psychologist, Health Service (Licence: KY 244492) | |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2022-12-20 |