| NPI | 1356719769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TN 3865) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103TC0700X Psychologist, Clinical (Licence: TN 3865) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-09-02 |
| Last Update Date | 2022-03-18 |