| NPI | 1033306733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL 8214) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-04-1585) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301012869) | |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2011-07-11 |