| NPI | 1265688782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.008443) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NY 1-09-5502) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NY 0137751) | |
| Enumeration Date | 2008-08-15 |
| Last Update Date | 2012-10-29 |