| NPI | 1952642852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY PSYLIP00211379) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KY 2012-88) |
| Enumeration Date | 2013-03-04 |
| Last Update Date | 2015-01-22 |