| 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 |