| NPI | 1801403472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 103TE1100X Psychologist, Exercise & Sports | |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2025-08-15 |