| NPI | 1639285471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CO 0004393) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TX 32016) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2021-06-02 |