| NPI | 1225262710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 25588) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TX 25588) |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2009-10-22 |