| NPI | 1629439724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS019190) |
| 103TC0700X Psychologist, Clinical (Licence: DE B1-0001153) | |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2022-01-24 |