| NPI | 1528078730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 3274) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 31157) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2016-05-18 |