| NPI | 1215239520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: OR 2203) |
| Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: OR 2203) |
| 103K00000X Behavior Analyst (Licence: TN 1-11-8303) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OR 2203) | |
| Enumeration Date | 2010-11-19 |
| Last Update Date | 2012-12-10 |