NPI | 1497011365 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA 31701) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MA 2122) |
Enumeration Date | 2012-04-05 |
Last Update Date | 2020-07-13 |