| NPI | 1457767535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS018928) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OH 7514) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2019-12-05 |