| NPI | 1356779722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20043404A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY 2013-70) |
| Enumeration Date | 2013-10-23 |
| Last Update Date | 2022-07-19 |