| NPI | 1083857932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 22603) |
| Additional Taxonomies | 103TF0200X Psychologist Forensic (Licence: TX 22603) |
| 103TH0100X Psychologist Health Service (Licence: TX 22306) | |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2011-11-30 |