| NPI | 1104000223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CO 1052143) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities | |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2019-03-01 |