| NPI | 1700339835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: AZ PSY-005758) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: AZ PSY-005758) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2024-11-07 |