| NPI | 1548575772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NM 1269) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 34160) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 34160) | |
| 103TF0200X Psychologist, Forensic (Licence: TX 34160) | |
| 103TF0200X Psychologist, Forensic (Licence: NM 1269) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NM 1269) | |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2013-08-22 |