NPI | 1336653997 |
---|---|
Former Name | NA NA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL BCBA-1-21-54770) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT3253) |
Enumeration Date | 2017-11-18 |
Last Update Date | 2022-12-06 |