| NPI | 1891855144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 129934) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KY 1445) |
| 103T00000X Psychologist (Licence: KY 129934) | |
| 103TC0700X Psychologist, Clinical (Licence: KY 1445) | |
| Enumeration Date | 2006-12-09 |
| Last Update Date | 2020-11-18 |