| NPI | 1235481474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 254879892) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 254879892) |
| 103K00000X Behavior Analyst (Licence: NY 254879892) | |
| Enumeration Date | 2012-10-12 |
| Last Update Date | 2012-10-12 |