| NPI | 1275707523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NC 1-07-3251) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 3368) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: NC 3368) | |
| 103TC0700X Psychologist Clinical (Licence: NC 3368) | |
| 171000000X Military Health Care Provider (Licence: 1-07-3251) | |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2023-03-22 |