| NPI | 1568584977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 25629) |
| Additional Taxonomies | 103TF0000X Psychologist Family (Licence: TX 25629) |
| 103TF0200X Psychologist Forensic (Licence: TX 25629) | |
| Enumeration Date | 2007-04-05 |
| Last Update Date | 2007-07-08 |