| NPI | 1114595196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MD 06983) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: MD 06983) |
| 103TC0700X Psychologist Clinical (Licence: MD 06983) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2023-06-30 |