NPI | 1831714138 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: KY 128999) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: KY 128999) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KY 128999) | |
Enumeration Date | 2020-06-11 |
Last Update Date | 2020-06-11 |