| NPI | 1063474823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 32417) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 04610) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2018-06-25 |