| NPI | 1639689003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 32168) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: TX 32168) |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2017-10-11 |