NPI | 1558716035 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX S6575) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX S6575) |
261QM0850X Clinic/Center, Adult Mental Health (Licence: TX BP10056555) | |
Enumeration Date | 2016-05-03 |
Last Update Date | 2021-07-26 |