NPI | 1003201187 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA LEP3560) |
Additional Taxonomies | 101YP1600X Counselor, Pastoral |
103K00000X Behavior Analyst (Licence: BCBA 1-14-9575) | |
Enumeration Date | 2015-04-05 |
Last Update Date | 2015-04-05 |