| NPI | 1326612565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH P.08186) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH APP-000432152) |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2022-04-05 |