| NPI | 1528255643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY9877) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810004827) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2017-08-29 |