| NPI | 1285708420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 31018) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY5874) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2019-06-03 |