| NPI | 1942896600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 37847) |
| 103TC1900X Psychologist, Counseling (Licence: TX 37847) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: TX 37847) | |
| Enumeration Date | 2020-12-17 |
| Last Update Date | 2021-11-08 |