| NPI | 1023022647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 38335) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA2105) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2024-09-10 |