| NPI | 1053060871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: LA LSSP018) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: TX 72142) |
| Enumeration Date | 2022-03-20 |
| Last Update Date | 2022-03-20 |