| NPI | 1700430170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS020003) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6352000564) |
| 103T00000X Psychologist (Licence: MI 6362002863) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 6352000564) | |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2023-10-16 |