| NPI | 1790655595 |
|---|---|
| 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: VT 097.0136559) |
| Enumeration Date | 2025-11-06 |
| Last Update Date | 2026-02-26 |