| 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 |