| NPI | 1710250014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 38421) |
| Additional Taxonomies | 101Y00000X Counselor |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-02-16 |
| Last Update Date | 2020-08-12 |