| NPI | 1639514383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: TX 36259) |
| Additional Taxonomies | 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: TX 36259) |
| 103TP2701X Psychologist Group Psychotherapy (Licence: TX 36259) | |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2023-12-11 |