| NPI | 1376168252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH P.08225) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH p.08225) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2022-01-06 |