| NPI | 1609177559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY 1723) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OH 6925) |
| 103TC0700X Psychologist, Clinical (Licence: KY 1723) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KY 1723) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: KY 1723) | |
| 103TF0000X Psychologist, Family (Licence: KY 1723) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: KY 1723) | |
| Enumeration Date | 2010-11-09 |
| Last Update Date | 2013-04-01 |