| NPI | 1700255197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 3451) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103T00000X Psychologist (Licence: OR 3451) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2024-11-11 |