NPI | 1134762941 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY10627) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL PY10627) |
Enumeration Date | 2019-10-24 |
Last Update Date | 2019-10-24 |