| NPI | 1366186108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 38780) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TX 38780) |
| Enumeration Date | 2022-04-27 |
| Last Update Date | 2022-05-02 |