| NPI | 1871571810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: KY 96225) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KY 96225) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2007-07-08 |