| NPI | 1952524647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: SC 5194) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: SC 4735) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2014-08-29 |