| NPI | 1922262948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KY KY-1555) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KY KY-1555) |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2018-03-17 |