| NPI | 1396247243 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6362008893)  | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6352000605)  | 
| 103TS0200X Psychologist, School | |
| 106S00000X Behavior Technician (Licence: MI RBT-17-43316)  | |
| 103K00000X Behavior Analyst (Licence: MI 1-20-41448)  | |
| Enumeration Date | 2018-03-07 | 
| Last Update Date | 2023-03-20 |