| NPI | 1104624956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 39204) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 39204) |
| Enumeration Date | 2025-03-06 |
| Last Update Date | 2025-03-17 |