| NPI | 1104849751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 30792) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: TX 30792) |
| 103TC1900X Psychologist, Counseling (Licence: TX 30792) | |
| 103TH0100X Psychologist, Health Service (Licence: TX 30792) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2007-07-09 |