| NPI | 1235620329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CT 4098) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CT 4098) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA 32467) | |
| 225C00000X Rehabilitation Counselor | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2023-07-11 |