| NPI | 1205133642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 36600) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY8236) |
| Enumeration Date | 2011-02-22 |
| Last Update Date | 2016-10-07 |