| NPI | 1891414546 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: Trainee) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC1900X Psychologist, Counseling (Licence: Trainee) | |
| Enumeration Date | 2022-08-25 |
| Last Update Date | 2024-09-06 |