| NPI | 1487202511 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 12367)  | 
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: TX 6081)  | 
| Enumeration Date | 2019-09-02 | 
| Last Update Date | 2019-09-02 |