| NPI | 1124591631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH ua413130) |
| 101YM0800X Counselor, Mental Health | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2019-01-07 |
| Last Update Date | 2026-05-15 |