| NPI | 1700130861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 36255) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 36255) |
| Enumeration Date | 2012-10-28 |
| Last Update Date | 2015-08-10 |