| NPI | 1508226705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 36487) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: TX 36487) |
| 172V00000X Community Health Worker (Licence: TX 36487) | |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2019-08-09 |