| NPI | 1497111777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 36920) |
| Additional Taxonomies | 103TF0200X Psychologist Forensic (Licence: TX 36920) |
| Enumeration Date | 2016-01-03 |
| Last Update Date | 2020-10-29 |