| NPI | 1922014166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 37288) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2003011958) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2019-10-14 |