| NPI | 1205095510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AL 1802) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AR 03-6E) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2018-05-01 |