| NPI | 1215441019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 71824) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-12-01 |
| Last Update Date | 2026-06-09 |