| NPI | 1427499623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 36387) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GU CP-40) |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2014-07-28 |