NPI | 1336645829 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: TX 34021) |
Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: TX 34021) |
Enumeration Date | 2018-04-03 |
Last Update Date | 2018-04-03 |