| NPI | 1548517493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: UT 9159603-2501) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: UT 9159603-2501) |
| 103TF0200X Psychologist, Forensic (Licence: UT 9159603-2501) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: UT 9159603-2501) | |
| 103TC1900X Psychologist, Counseling (Licence: UT 9159603-2501) | |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2017-02-13 |