| NPI | 1669771804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 34861) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: 7661) |
| Enumeration Date | 2011-03-25 |
| Last Update Date | 2025-03-26 |