| NPI | 1821498510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 37709) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY8692) |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2021-07-15 |