| NPI | 1225721186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6352000882) |
| Enumeration Date | 2023-05-29 |
| Last Update Date | 2024-01-23 |