| NPI | 1710326756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 36445) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: TX 70292) |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2020-03-04 |