| NPI | 1508191867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CO PSY.0003953) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: SC 1128) |
| 103T00000X Psychologist (Licence: TX 32942) | |
| 103TS0200X Psychologist, School (Licence: TX 33194) | |
| Enumeration Date | 2009-10-05 |
| Last Update Date | 2017-04-05 |