| NPI | 1407290711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301010450) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MI 6301010450) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2018-05-18 |