| NPI | 1801375225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: KS 2744) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MO 2021034706) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2022-09-30 |