| NPI | 1316446529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TH0100X Psychologist Health Service (Licence: KS 40088) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: KS 40088) |
| 103TP2701X Psychologist Group Psychotherapy (Licence: IN 28340) | |
| Enumeration Date | 2018-02-03 |
| Last Update Date | 2018-05-14 |