| NPI | 1225260193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 34471) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MD 04587) |
| Enumeration Date | 2009-08-11 |
| Last Update Date | 2021-10-18 |