| NPI | 1396028452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 020994) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY10706) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2023-01-30 |