NPI | 1518285675 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY19913) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: BCBA-D 1-00-0003) |
Enumeration Date | 2010-05-12 |
Last Update Date | 2010-05-12 |