NPI | 1003028804 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-20-41101) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL IMT 658) |
Enumeration Date | 2007-05-04 |
Last Update Date | 2024-02-29 |