| NPI | 1083926570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 20517) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AL 1915) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2021-05-03 |