| NPI | 1093526527 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 102X00000X Poetry Therapist |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| 103TS0200X Psychologist, School | |
| Enumeration Date | 2025-01-15 |
| Last Update Date | 2025-01-15 |