| NPI | 1003002015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 34408) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 21664) |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2020-06-22 |