| NPI | 1356071880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH P.08607) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA BSP94026675) |
| Enumeration Date | 2022-06-16 |
| Last Update Date | 2024-03-14 |