| NPI | 1740502269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY 1698) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: 2009-89) |
| Enumeration Date | 2010-02-25 |
| Last Update Date | 2015-05-21 |