| NPI | 1265008650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 18100) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-04-1921) |
| Enumeration Date | 2021-05-27 |
| Last Update Date | 2021-05-27 |