NPI | 1396187100 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS017522) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MD 05177) |
Enumeration Date | 2013-07-22 |
Last Update Date | 2016-08-02 |