| NPI | 1104281039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2021036406) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 10817) |
| 103K00000X Behavior Analyst (Licence: NE 1-15-19749) | |
| Enumeration Date | 2015-12-18 |
| Last Update Date | 2021-12-28 |