| NPI | 1518373307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 39675) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: TX 68729) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2023-04-25 |