| NPI | 1629682265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810007966) |
| 103K00000X Behavior Analyst (Licence: VA 0133002734) | |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2022-10-14 |