| NPI | 1699291666 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 38182) | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA 29296) | 
| Enumeration Date | 2017-08-21 | 
| Last Update Date | 2019-06-12 |