| NPI | 1891975421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ 3869) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 33319) |
| Enumeration Date | 2007-11-12 |
| Last Update Date | 2010-03-25 |