| NPI | 1962478958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: TX 23569) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: TX 23569) |
| 103TC1900X Psychologist Counseling (Licence: TX 23569) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2017-05-05 |