| NPI | 1710124219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 165023) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KY PSYPPR00225268) |
| Enumeration Date | 2009-01-21 |
| Last Update Date | 2024-08-01 |