| NPI | 1841767860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PR 7617) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: PR 7617) |
| 103TF0000X Psychologist, Family (Licence: PR 7617) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: PR 7617) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-10-29 |
| Last Update Date | 2023-07-25 |