| NPI | 1235269721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CT 2991) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CT 1-14-15426) |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 103TF0200X Psychologist Forensic | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities | |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2015-02-13 |