| NPI | 1962632398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY 174212) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: KY 138733) |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2024-01-24 |