| NPI | 1962844266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 24682) |
| Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: TX 4682) |
| 103TS0200X Psychologist, School (Licence: TX 30361) | |
| Enumeration Date | 2013-07-27 |
| Last Update Date | 2019-02-06 |