| NPI | 1508111873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NY 000509) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 9649) |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2021-01-21 |