| NPI | 1629747845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 38661) |
| Additional Taxonomies | 103TS0200X Psychologist School (Licence: TX 70801) |
| Enumeration Date | 2021-09-10 |
| Last Update Date | 2021-09-10 |