| NPI | 1295088003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 37909) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MD 05184) |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2018-07-05 |