| NPI | 1649750753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 39532) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: FL PY10222) |
| Enumeration Date | 2018-08-17 |
| Last Update Date | 2022-12-06 |