| NPI | 1366718884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 30722) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VA A62458719) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2022-01-03 |