| NPI | 1649680679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 38860) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 38860) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 12702) | |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2025-09-25 |