| NPI | 1366071003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA PSY10000763) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 103TC0700X Psychologist, Clinical (Licence: PA PS019713) | |
| Enumeration Date | 2020-04-04 |
| Last Update Date | 2024-07-09 |