NPI | 1972699692 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 24437) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 24437) |
103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
103TB0200X Psychologist, Cognitive & Behavioral | |
103T00000X Psychologist | |
Enumeration Date | 2006-10-04 |
Last Update Date | 2024-11-11 |