| NPI | 1538389838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 35016) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 1114) |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2011-07-29 |