| NPI | 1255614194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2019-02-20 |