| NPI | 1194351221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH P.08028) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY33876) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2025-11-13 |