| NPI | 1649762790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AL 2266) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 38846) |
| 103TC1900X Psychologist, Counseling (Licence: AL 2266) | |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2022-06-28 |