| NPI | 1760842223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X (Licence: KY PSYPAT00222587) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KY PSYPAT00222587) |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2016-02-26 |