| NPI | 1871646067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY 114285) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: KY 0052) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2023-09-15 |