| NPI | 1689318792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 07166) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MD 390200000X) |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2024-06-24 |