| NPI | 1275879777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: HI 2190) |
| 106S00000X Behavior Technician | |
| 103TC0700X Psychologist, Clinical (Licence: TX 40156) | |
| Enumeration Date | 2013-01-02 |
| Last Update Date | 2024-08-16 |