| NPI | 1518369354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 37333) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 37333) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: TX 37333) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: TX 37333) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: TX 37333) | |
| 103TS0200X Psychologist School (Licence: TX 70552) | |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2024-12-09 |