NPI | 1013075258 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: UT 115371-2501) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY7242) |
Enumeration Date | 2006-12-04 |
Last Update Date | 2010-12-06 |