| NPI | 1740570043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: 40522) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC0700X Psychologist, Clinical (Licence: TX 40522) | |
| 103TF0200X Psychologist, Forensic (Licence: TX 40522) | |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2025-04-17 |