| NPI | 1053540633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 36970) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2020029141) |
| Enumeration Date | 2009-07-05 |
| Last Update Date | 2023-10-29 |