| NPI | 1124112040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 12405) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 13342) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2025-09-11 |