| NPI | 1639928153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: VT 8064708) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: VT 8064708) |
| Enumeration Date | 2024-05-16 |
| Last Update Date | 2024-10-30 |