| NPI | 1790277499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 38727) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 6471) |
| 103TC0700X Psychologist, Clinical (Licence: NC 6471) | |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2023-11-10 |