| 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 |