| NPI | 1164845053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: PR 5546) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: PR 5546) |
| 103TC1900X Psychologist, Counseling (Licence: PR 5546) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: PR 5546) | |
| 106H00000X Marriage & Family Therapist (Licence: PR 5546) | |
| Enumeration Date | 2014-01-28 |
| Last Update Date | 2014-01-28 |