| NPI | 1063905214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CO PSY.0005389) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 11515) |
| 103K00000X Behavior Analyst (Licence: 1-19-38500) | |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2021-02-23 |