| NPI | 1003576042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IA 111034) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: IA 111034) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: IA 111034) | |
| 103TS0200X Psychologist, School (Licence: IA 111034) | |
| Enumeration Date | 2021-12-17 |
| Last Update Date | 2021-12-17 |