| NPI | 1811330020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 16829) |
| Additional Taxonomies | 103TH0004X Psychologist Health (Licence: TX 16829) |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2013-05-30 |