NPI | 1063627941 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: TX 32037) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 32037) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 32037) | |
Enumeration Date | 2007-05-13 |
Last Update Date | 2019-05-15 |