| NPI | 1912120668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 32758) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 32758) |
| 103TS0200X Psychologist, School (Licence: TX 30974) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2007-07-08 |