| NPI | 1649728452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY 289899) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NC 5035) |
| 103TC1900X Psychologist, Counseling (Licence: KY 289899) | |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2025-06-29 |