| NPI | 1700142767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ PSY-005397) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 40524) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2025-08-12 |