| NPI | 1770680100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 21120) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: TX 6626) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2007-07-08 |