| NPI | 1619377611 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103T00000X Psychologist | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 101YS0200X Counselor, School | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-08-26 | 
| Last Update Date | 2016-08-18 |