| NPI | 1285984971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401013264) |
| 103TC0700X Psychologist, Clinical (Licence: MI 6301015268) | |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2018-10-30 |