| NPI | 1669603932 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 34652)  | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA 22475)  | 
| Enumeration Date | 2009-08-04 | 
| Last Update Date | 2014-01-13 |