| NPI | 1992701577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TN 2307) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 32291) |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2023-10-16 |