| NPI | 1922710037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 285437) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 272366) |
| Enumeration Date | 2022-12-20 |
| Last Update Date | 2023-07-17 |