| NPI | 1801081443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 9706) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY25397) |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2013-08-26 |