| NPI | 1275206559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 298024) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TN LPC0000005384) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-08-01 |
| Last Update Date | 2025-11-06 |