| NPI | 1538605738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 07027) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2023-10-03 |