| NPI | 1982712691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral (Licence: TX 23773) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TX TX23773) |
| 103TC1900X Psychologist Counseling (Licence: TX TX23773) | |
| 103TF0000X Psychologist Family (Licence: TX TX23773) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2007-07-08 |