| NPI | 1891989646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 169254) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TN P2733) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: TN P2733) | |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2018-03-17 |