| NPI | 1093831372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: UT 294681-2501) |
| Additional Taxonomies | 103TS0200X Psychologist School |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2010-02-04 |