| NPI | 1922598531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TN 3655) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NE 11466) |
| 103T00000X Psychologist (Licence: TN 3655) | |
| 103TS0200X Psychologist School (Licence: TN 3655) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2022-08-12 |