| NPI | 1962774406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 33724) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: TX 32497) |
| Enumeration Date | 2012-01-30 |
| Last Update Date | 2012-01-30 |