| NPI | 1760447585 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 39542)  | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA 1969)  | 
| Enumeration Date | 2006-04-18 | 
| Last Update Date | 2025-03-13 |