NPI | 1356704449 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DC PSY1001496) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
390200000X Student in an Organized Health Care Education/Training Program (Licence: LA 1469) | |
Enumeration Date | 2016-04-05 |
Last Update Date | 2019-05-09 |