| NPI | 1780026625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 31917) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA Trainee) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA Trainee) | |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2020-07-16 |