| NPI | 1861894636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 36755) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: TX 36755) |
| 103TS0200X Psychologist, School (Licence: TX 70120) | |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2015-11-11 |