| NPI | 1104054329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-12-12557) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN 5121) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2020-02-12 |