| NPI | 1598020828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 1680) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 4223) |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2012-10-31 |