| NPI | 1437802311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: MN J650172588111) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MN J650172588111) |
| Enumeration Date | 2022-01-31 |
| Last Update Date | 2022-01-31 |