| NPI | 1518949163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 24283) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 24283) |
| 103TH0100X Psychologist, Health Service (Licence: TX 24283) | |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2013-05-29 |