| NPI | 1790973998 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: UT 12226713-2501)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 3369)  | 
| 103TS0200X Psychologist, School (Licence: CO RN143287)  | |
| Enumeration Date | 2007-10-12 | 
| Last Update Date | 2021-11-03 |