| NPI | 1841176559 |
|---|---|
| Former Name | IVY CHARLOTTE GOSNELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 35666) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA 35666) |
| 103TH0004X Psychologist, Health (Licence: CA 35666) | |
| Enumeration Date | 2025-08-15 |
| Last Update Date | 2025-08-15 |