| NPI | 1578919478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 39004) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TN P3406) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2023-06-19 |