| NPI | 1962753491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 37762) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103T00000X Psychologist (Licence: TX 37762) | |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2023-08-01 |