| NPI | 1457841561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6361008013) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2024-11-05 |