| NPI | 1225202567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NC 1-03-1173) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: NC 2432) |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: NC 2432) | |
| 171000000X Military Health Care Provider (Licence: 1-03-1173) | |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2009-09-17 |