| NPI | 1376893735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 6002) |
| Additional Taxonomies | 103TF0000X Psychologist, Family (Licence: PR 6002) |
| 103TH0004X Psychologist, Health (Licence: PR 6002) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2022-01-17 |