| NPI | 1740563279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 35170) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 018617) |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2011-09-21 |