| NPI | 1922643691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 37903) |
| Additional Taxonomies | 103TH0100X Psychologist Health Service (Licence: TX 37903) |
| Enumeration Date | 2019-11-16 |
| Last Update Date | 2021-06-11 |