| NPI | 1619017506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY 135918) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KY 2006-35) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2018-10-31 |