| NPI | 1255757845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: UT 79337592501) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA 19114) |
| Enumeration Date | 2014-03-06 |
| Last Update Date | 2014-03-06 |