| NPI | 1083080360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS019576) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 022747) |
| 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00615200) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2023-03-21 |