| NPI | 1134719784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103TC1900X Psychologist Counseling | |
| 106S00000X Behavior Technician | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-01-18 |
| Last Update Date | 2024-02-14 |