| NPI | 1902638778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TF0000X Psychologist, Family |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-08-19 |
| Last Update Date | 2024-09-03 |