| NPI | 1235132499 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 2895) | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 31887) | 
| Enumeration Date | 2005-05-23 | 
| Last Update Date | 2020-11-18 |