| NPI | 1265090658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: LA 1665) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-05-31 |
| Last Update Date | 2024-03-01 |