| NPI | 1619121944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY KY-129385) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TN 2815) |
| Enumeration Date | 2008-11-13 |
| Last Update Date | 2025-04-08 |