| NPI | 1407124597 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: TX 08510) | 
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 08510) | 
| 103TF0000X Psychologist, Family (Licence: TX 08510) | |
| Enumeration Date | 2011-12-05 | 
| Last Update Date | 2011-12-05 |