| NPI | 1619099744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY KY-1424) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: KY 000066493) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2016-06-29 |