NPI | 1053816132 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35S100654600) |
Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS019084) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-03-29 |
Last Update Date | 2025-01-24 |