| NPI | 1710057518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TN P2955) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 31857) |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2022-03-30 |