| NPI | 1033110812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 22596) |
| Additional Taxonomies | 103TF0000X Psychologist Family (Licence: TX 001559-042699) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2007-07-08 |