| NPI | 1932219284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IA 099727) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO 2789) |
| 103TC0700X Psychologist, Clinical (Licence: TX 32845) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-04-29 |