| NPI | 1902285646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NM PSY1514) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 10091) |
| 103TC0700X Psychologist Clinical (Licence: NM 1514) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2022-06-13 |