| NPI | 1225582265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NV PY1053) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA 30396627) |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2022-03-01 |