NPI | 1801129382 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 35183) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: TX 70014) |
Enumeration Date | 2009-09-15 |
Last Update Date | 2012-07-18 |