| NPI | 1225368723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: WI 2387-57) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WI 2387-57) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| Enumeration Date | 2010-01-05 |
| Last Update Date | 2010-01-05 |