| NPI | 1407293137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 36413) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: TX 36413) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2024-10-02 |