| NPI | 1356788905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: HI 1195) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TX 31115) |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2013-05-22 |