| NPI | 1023140522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 36607) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: HI PSY652) |
| Enumeration Date | 2007-03-10 |
| Last Update Date | 2015-08-31 |