| NPI | 1679297345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 7764) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY11927) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL PPY336) | |
| Enumeration Date | 2022-09-27 |
| Last Update Date | 2024-03-22 |