| NPI | 1932557204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MD 06126) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: DE B1-0001098) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2022-09-20 |