| NPI | 1134533359 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 36731) | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 36731) | 
| 103TC0700X Psychologist, Clinical (Licence: TX 81-1725911) | |
| Enumeration Date | 2014-06-16 | 
| Last Update Date | 2024-05-07 |