| NPI | 1023202322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 36065) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: PR 2176) |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2013-01-25 |