| NPI | 1912692104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 38683) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 38683) |
| Enumeration Date | 2023-04-05 |
| Last Update Date | 2023-08-10 |