| NPI | 1942257563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AR 06-01P) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TX 33129) |
| 103TC0700X Psychologist Clinical (Licence: UT 95-308788-2501) | |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2008-05-09 |