| NPI | 1871523308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 33305) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AL 1447) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2007-07-08 |