| NPI | 1154894889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 41297) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2026-08-04 |