| NPI | 1770911554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 129229) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 1736) |
| Enumeration Date | 2013-10-14 |
| Last Update Date | 2025-08-27 |