| NPI | 1588142061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 38033) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: NM 1374) |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2020-08-27 |