| NPI | 1295336501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2022-07-18 |