| NPI | 1588703623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: KS LMLP0160) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KS LCP 267) |
| 106H00000X Marriage & Family Therapist (Licence: KS LCMFT 173) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2007-07-08 |