| NPI | 1578711768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: TX 36599) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2017-03-27 |