| NPI | 1164780995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 37535) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 65630) |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2017-02-17 |