NPI | 1114621737 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CO PSYC.00015020) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CO 1-21-51634) |
Enumeration Date | 2023-03-28 |
Last Update Date | 2023-06-13 |