| NPI | 1205113511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 3564) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NC 3564) | |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2022-11-29 |