| NPI | 1003316514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 5374-57) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 13489) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2025-05-20 |