| NPI | 1568068641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 103TF0000X Psychologist, Family |
| Enumeration Date | 2020-12-05 |
| Last Update Date | 2020-12-18 |