| NPI | 1053665620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: TX NA8663653) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 00312557) |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2015-10-26 |