| NPI | 1124490651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 4446) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-08-4249) |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2020-10-27 |