| NPI | 1225440977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 4014) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO PSY.0005041) |
| 103TC0700X Psychologist, Clinical (Licence: NY 024277-01) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2023-02-28 |