| NPI | 1942327234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 4275) |
| Additional Taxonomies | 103TF0200X Psychologist Forensic (Licence: TX 4275) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2016-02-14 |