| NPI | 1912008814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 129064) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY KY 0970) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-06-17 |