| NPI | 1023223609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 30757) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 30757) |
| 101YM0800X Counselor, Mental Health (Licence: TX 30757) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 30757) | |
| 101Y00000X Counselor (Licence: TX 30757) | |
| 103TH0004X Psychologist, Health (Licence: TX 30757) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2011-04-03 |