| NPI | 1639546773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 000) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2021-03-29 |