| NPI | 1215737036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-12-12327) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA 3156) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA 3156) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: CA 3156) | |
| 103TS0200X Psychologist, School (Licence: CA 3156) | |
| Enumeration Date | 2025-03-19 |
| Last Update Date | 2025-03-19 |