| NPI | 1356993406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IL 071010135) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: IL 178009553) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2019-12-29 |