| NPI | 1760751705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 35076) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: TX 34421) |
| Enumeration Date | 2011-12-20 |
| Last Update Date | 2012-03-16 |