| NPI | 1003968108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 24439) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 24439) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: TX 24439) | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2012-09-25 |