| NPI | 1952970519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 32261) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TX 38819) |
| Enumeration Date | 2021-06-18 |
| Last Update Date | 2021-06-18 |