| NPI | 1346642956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR R249) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR 23-QMHP-R-2380) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2023-10-24 |