| NPI | 1073884540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 35055) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810004935) |
| Enumeration Date | 2012-01-15 |
| Last Update Date | 2022-02-07 |