| NPI | 1285027367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CO 0005490) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 022549) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-12 |
| Last Update Date | 2024-03-04 |