NPI | 1104345321 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 38480) |
Additional Taxonomies | 222Q00000X Developmental Therapist |
Enumeration Date | 2017-09-19 |
Last Update Date | 2025-04-02 |