| NPI | 1508960063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: UT 134765-2501) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: UT 134765-2501) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2020-01-29 |