| NPI | 1245399377 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 33849)  | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2006027462)  | 
| Enumeration Date | 2006-12-06 | 
| Last Update Date | 2009-05-12 |