| NPI | 1063633972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 36102) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY 7357) |
| 103TC0700X Psychologist, Clinical (Licence: TX 36102) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2012-04-03 |