NPI | 1164981288 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TS0200X Psychologist, School (Licence: CA 160049502) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-11-8591) |
103T00000X Psychologist (Licence: CA 3064) | |
Enumeration Date | 2019-03-18 |
Last Update Date | 2019-03-18 |