| NPI | 1689038481 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: TX 30510) | 
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: TX 11557) | 
| Enumeration Date | 2016-04-07 | 
| Last Update Date | 2016-04-07 |