| NPI | 1518255009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-12-1015) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: CA LEP3111) | |
| 103TC1900X Psychologist Counseling (Licence: CA LEP3111) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: CA LEP3111) | |
| 103TS0200X Psychologist School (Licence: CA LEP3111) | |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2021-05-27 |