| NPI | 1659495653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 31723) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA PSY 18763) |
| Enumeration Date | 2007-03-17 |
| Last Update Date | 2013-04-22 |