| 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 |