| NPI | 1174040679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: CA 3148) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 3148) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA 3148) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: CA 3148) | |
| Enumeration Date | 2017-08-25 |
| Last Update Date | 2017-08-25 |