| NPI | 1295102978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: TX 37137) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: AL 667) |
| 103TH0100X Psychologist Health Service (Licence: TN 2706) | |
| Enumeration Date | 2015-08-28 |
| Last Update Date | 2018-08-26 |