| NPI | 1003037441 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 35017)  | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MS 36-654)  | 
| 103TC0700X Psychologist, Clinical (Licence: TN 2826)  | |
| Enumeration Date | 2007-05-02 | 
| Last Update Date | 2024-05-21 |