| NPI | 1588249064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 126800000X Dental Assistant |
| 171M00000X Case Manager/Care Coordinator | |
| 171W00000X Contractor | |
| 174H00000X Health Educator | |
| Enumeration Date | 2021-03-16 |
| Last Update Date | 2021-11-04 |