| NPI | 1619557493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NM psy-2023-0056) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 70930) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2023-09-01 |