| NPI | 1013078963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 23065) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: TX 23065) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 23065) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2008-09-08 |