| NPI | 1457386963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NM PSY1470) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NM PSY1470) |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: NM PSY1470) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2020-04-30 |