| NPI | 1275617821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-07-3417) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39001746A) |
| 101YM0800X Counselor, Mental Health (Licence: OR C2213) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2014-03-07 |