| NPI | 1356883003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361008044) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6362009539) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2016-11-11 |
| Last Update Date | 2024-08-21 |