NPI | 1114226974 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY8731) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-11-8006) |
Enumeration Date | 2011-03-19 |
Last Update Date | 2013-04-08 |