| NPI | 1104945070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MD 03945) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD 03945) |
| 103K00000X Behavior Analyst (Licence: MD LBA1750) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MD 03945) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MD 03945) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2024-02-14 |