| NPI | 1801238993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 128156) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 1005) |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2017-04-18 |