| NPI | 1033565627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA 30308) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NE 10855) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2018-09-17 |