NPI | 1023408903 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY34762) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
106S00000X Behavior Technician | |
252Y00000X Early Intervention Provider Agency | |
Enumeration Date | 2015-01-29 |
Last Update Date | 2024-08-01 |