| NPI | 1306209317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: UT 9518522-2501) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: UT 9518522-2504) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2021-12-01 |