| NPI | 1306068051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 24154) |
| Additional Taxonomies | 103TE1100X Psychologist, Exercise & Sports (Licence: TX 24154) |
| 103TC1900X Psychologist, Counseling (Licence: TX 24154) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2022-08-27 |