| NPI | 1871653071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA 60701887) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY24595) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 31881032701) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2024-05-13 |