| NPI | 1548865124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 40454) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: TX 40454) |
| 103TS0200X Psychologist School | |
| Enumeration Date | 2020-12-02 |
| Last Update Date | 2024-12-10 |