| NPI | 1063813640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 36822) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC1900X Psychologist, Counseling (Licence: 36822) | |
| 103TF0000X Psychologist, Family (Licence: 36822) | |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2014-09-15 |