| NPI | 1518696939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: TX 31192) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 15256) |
| Enumeration Date | 2022-06-09 |
| Last Update Date | 2022-06-09 |