| NPI | 1467783159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 34294) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: TX 34294) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: TX 34294) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: TX 34294) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: TX 34294) | |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2024-02-07 |