| NPI | 1912241308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 36782) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MO 2012033734) |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2018-04-11 |