| NPI | 1366947590 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: MD 07029)  | 
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: TX 1-18-29448)  | 
| 103K00000X Behavior Analyst (Licence: TX 1406)  | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-28 | 
| Last Update Date | 2023-09-07 |