| NPI | 1255675005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301014788) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MI 1-11-9594) |
| Enumeration Date | 2012-11-17 |
| Last Update Date | 2023-04-14 |