| NPI | 1639588379 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 37616) | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 37616) | 
| Enumeration Date | 2014-08-07 | 
| Last Update Date | 2024-02-27 |