| NPI | 1992908636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 130730) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103TC0700X Psychologist, Clinical (Licence: KY 1709) | |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2023-04-03 |