| NPI | 1174097133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KS 2317) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: KS 028) |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2022-03-14 |