| NPI | 1508999327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 23665) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 2489) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2007-07-08 |