NPI | 1215252473 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 12841) |
Additional Taxonomies | 103K00000X Behavior Analyst |
103TC0700X Psychologist, Clinical (Licence: AZ 3956) | |
103TC0700X Psychologist, Clinical (Licence: TX 32972) | |
Enumeration Date | 2010-03-31 |
Last Update Date | 2022-09-02 |