| NPI | 1922246016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 168058) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WV 970) |
| Enumeration Date | 2009-01-27 |
| Last Update Date | 2016-07-08 |