| NPI | 1063504306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 25540) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: TX 30085) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2016-04-27 |