| NPI | 1508401266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist School |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities | |
| Enumeration Date | 2019-11-16 |
| Last Update Date | 2019-11-16 |