| NPI | 1598495657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CO PSY.0005928) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO PSYC.00014811) |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2022-10-18 |