| NPI | 1760910285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 37505) |
| Additional Taxonomies | 103TP2701X Psychologist Group Psychotherapy |
| 103TC1900X Psychologist Counseling | |
| Enumeration Date | 2017-05-28 |
| Last Update Date | 2017-05-28 |