| NPI | 1710959101 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 38305) | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IN 20041928A) | 
| Enumeration Date | 2006-02-01 | 
| Last Update Date | 2024-10-24 |