NPI | 1194244152 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.010241) |
Additional Taxonomies | 225C00000X Rehabilitation Counselor |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-09-11 |
Last Update Date | 2020-01-28 |