| NPI | 1902237837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TS0200X Psychologist School (Licence: VA PPS-0604541) |
| Additional Taxonomies | 103TS0200X Psychologist School (Licence: TX 70697) |
| Enumeration Date | 2013-12-03 |
| Last Update Date | 2025-10-08 |