| NPI | 1841659323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WY 596) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WY 592) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-02-12 |
| Last Update Date | 2022-03-22 |