| NPI | 1407522907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: SC 1884) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-21-52023) |
| 103T00000X Psychologist (Licence: CO Psy.0006339) | |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2024-07-23 |