| NPI | 1386993251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 37922) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2019-06-20 |