| NPI | 1477038818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 4755) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301019009) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-10-02 |
| Last Update Date | 2024-07-18 |