| NPI | 1780092361 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: TX 32367)  | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 33496)  | 
| Enumeration Date | 2014-07-28 | 
| Last Update Date | 2014-07-28 |