| NPI | 1831714096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY 1191) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: KY 1191) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KY 1191) | |
| 103TF0000X Psychologist, Family (Licence: KY 1191) | |
| Enumeration Date | 2020-06-13 |
| Last Update Date | 2020-06-13 |