| NPI | 1053851493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MI 6801093831) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: MI 6801093831) |
| Enumeration Date | 2017-03-05 |
| Last Update Date | 2017-03-05 |