| NPI | 1265998934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6362009745) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-02-18 |
| Last Update Date | 2023-08-01 |