| NPI | 1700266632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 33694) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WA PY60253699) |
| 103TS0200X Psychologist, School (Licence: TX 35228) | |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2015-06-05 |