| NPI | 1225739766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TS0200X Psychologist School |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: WV RBT-22-229357) |
| Enumeration Date | 2023-03-13 |
| Last Update Date | 2025-07-15 |