| NPI | 1417358078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ PSY-005742) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY10339) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2025-01-15 |