| NPI | 1265602445 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 37749) | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PR 2946) | 
| Enumeration Date | 2008-03-04 | 
| Last Update Date | 2024-02-27 |