| NPI | 1699841643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 25300) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NM PSY1696) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2024-08-03 |