| NPI | 1174109276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 38624) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: TX 71870) |
| Enumeration Date | 2021-03-20 |
| Last Update Date | 2021-03-20 |