| NPI | 1689122582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY 170917) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 166495) |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2024-11-03 |