| NPI | 1639787062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 32957) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist, Clinical (Licence: NY 024035) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2022-01-12 |