| NPI | 1780915389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: KY 129003) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: 2009-14) |
| 103TC0700X Psychologist Clinical (Licence: KY 2009-104) | |
| Enumeration Date | 2010-01-21 |
| Last Update Date | 2017-11-06 |