NPI | 1386788909 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 30845) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: TX 31196) |
Enumeration Date | 2007-02-16 |
Last Update Date | 2007-07-08 |