| NPI | 1386986412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: ID PSY-203029) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 103T00000X Psychologist (Licence: VA 0810005625) | |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2017-09-14 |