| NPI | 1811567258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| 103T00000X Psychologist | |
| Enumeration Date | 2021-06-28 |
| Last Update Date | 2024-07-08 |