NPI | 1134132624 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 23331) |
Additional Taxonomies | 103T00000X Psychologist (Licence: TX 23331) |
103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: TX 23331) | |
106H00000X Marriage & Family Therapist (Licence: TX 000790042884) | |
Enumeration Date | 2006-08-14 |
Last Update Date | 2024-10-01 |