| NPI | 1518309335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY P95228) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NE 9795) |
| 103K00000X Behavior Analyst (Licence: NY 000432) | |
| Enumeration Date | 2013-07-22 |
| Last Update Date | 2016-01-26 |