NPI | 1891142568 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MD 05887) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-05-23 |
Last Update Date | 2019-12-31 |