| NPI | 1588064034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.010063) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL A165-0099-0735) |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2019-07-23 |