| NPI | 1205851995 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 5154)  | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: AZ 005597)  | 
| 103T00000X Psychologist (Licence: CO 0006061)  | |
| 103TC0700X Psychologist, Clinical (Licence: TX 24625)  | |
| 103TS0200X Psychologist, School (Licence: TX 30404)  | |
| Enumeration Date | 2006-07-13 | 
| Last Update Date | 2024-08-06 |