| NPI | 1124385216 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-04-1576) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCS10562) | 
| Enumeration Date | 2012-04-13 | 
| Last Update Date | 2012-04-13 |