| NPI | 1477522258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 22875) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 2-2875) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2018-12-10 |