| NPI | 1023425287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY 5456) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-01-0526) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: FL PY 5456) | |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2022-05-13 |