| NPI | 1154630978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 118902) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MA 660) |
| 103K00000X Behavior Analyst (Licence: MA 1-15-18990) | |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2016-10-26 |