| NPI | 1164642617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 36584) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 3065-57) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2014-06-18 |