| NPI | 1679918239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 38804) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 38804) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2022-09-02 |