| NPI | 1558304543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 22661) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: TX 2-2661) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: TX 2-2661) | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: TX 2-2661) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 2-2661) | |
| 103TF0200X Psychologist, Forensic (Licence: TX 2-2661) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2012-05-22 |