| NPI | 1023694395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IL 071-011334) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA MC61158586) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-18 |
| Last Update Date | 2024-12-03 |