| NPI | 1457782062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 33419) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: TX 33419) |
| 171000000X Military Health Care Provider (Licence: TX 33419) | |
| Enumeration Date | 2013-12-06 |
| Last Update Date | 2024-07-23 |