NPI | 1609258292 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CT 3674) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
103TC2200X Psychologist, Clinical Child & Adolescent | |
Enumeration Date | 2015-06-19 |
Last Update Date | 2022-09-23 |