NPI | 1467049163 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6352001075) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2020-12-29 |
Last Update Date | 2025-08-11 |