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 |