| NPI | 1568712289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2014027023) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TH0004X Psychologist, Health (Licence: KS LP02998) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2022-03-08 |