| NPI | 1972699692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: TX 24437) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2024-06-12 |