| NPI | 1053866079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: LA 1274) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: LA L-044) |
| Enumeration Date | 2016-08-19 |
| Last Update Date | 2016-08-19 |