| NPI | 1730791070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY33602) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WA PY61286126) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2023-02-13 |