| NPI | 1770029746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AZ 0005234) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: AZ 005234) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-01-13 |
| Last Update Date | 2022-07-19 |