| NPI | 1649524091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 36539) |
| Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: TX 36539) |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2015-12-22 |