NPI | 1154013282 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 025841) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 025841) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2023-05-25 |
Last Update Date | 2023-12-14 |