| NPI | 1497973036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MD 04716) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH00007347) |
| 103K00000X Behavior Analyst (Licence: MD 04716) | |
| 103TC0700X Psychologist, Clinical (Licence: MD 04716) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2016-09-21 |