| NPI | 1508047978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: TX 33639) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TX 33639) |
| 103TH0004X Psychologist Health (Licence: TX 33639) | |
| Enumeration Date | 2007-11-14 |
| Last Update Date | 2007-11-14 |