| NPI | 1649619461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301018892) |
| 103TC0700X Psychologist, Clinical (Licence: CA 30992) | |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2022-08-22 |