| NPI | 1821432030 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 2866) | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OR 2866) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-18 | 
| Last Update Date | 2024-11-27 |