NPI | 1992352140 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: OK 1441) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-21-55835) |
103TC0700X Psychologist, Clinical (Licence: CO PSY.0005606) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-08-22 |
Last Update Date | 2024-12-20 |