| NPI | 1831126903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 0068) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 83) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2011-10-10 |