NPI | 1184141384 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 36226) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: TX 70081) |
Enumeration Date | 2017-08-28 |
Last Update Date | 2017-08-28 |