| NPI | 1699123075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: TX 36704) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: TX 36704) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: TX 36704) | |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2018-03-17 |