| NPI | 1740292705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 33852) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 11312) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2021-12-03 |