| NPI | 1811435761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 06543) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810007358) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2021-06-25 |