| NPI | 1174658629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-12-10213) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180.012570) |
| 222Q00000X Developmental Therapist (Licence: IL KW48321203P) | |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2019-11-25 |