| NPI | 1477713014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AL 1634) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NE 8621) |
| 103K00000X Behavior Analyst (Licence: 1-05-2487-2005) | |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2010-09-22 |