| NPI | 1114180064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: SD 1-03-1438) |
| 103T00000X Psychologist (Licence: SD 419) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2021-07-22 |