| NPI | 1992109862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY PSYLIP00210710) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NH 1240) |
| 103T00000X Psychologist (Licence: NY 016297-1) | |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2019-08-18 |