| NPI | 1134470271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AZ PSY-005288) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: AZ PSY-005288) |
| 103TF0200X Psychologist Forensic (Licence: AZ PSY-005288) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: AZ PSY-005288) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2022-03-17 |