| NPI | 1114947579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 23696) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NM 614) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2009-05-01 |