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 |