NPI | 1417475120 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 026647) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2017-09-01 |
Last Update Date | 2024-08-28 |