| NPI | 1366091373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY61018614) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103K00000X Behavior Analyst (Licence: 1-20-45979) | |
| Enumeration Date | 2019-09-11 |
| Last Update Date | 2021-01-26 |