| NPI | 1730566308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 36929) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: TX 36929) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: TX 36929) | |
| Enumeration Date | 2015-05-02 |
| Last Update Date | 2016-01-29 |