| NPI | 1760180111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: FL PRE-LICENSED) |
| Enumeration Date | 2023-02-15 |
| Last Update Date | 2023-02-15 |