NPI | 1548694367 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA 30658) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1118920) |
Enumeration Date | 2013-08-28 |
Last Update Date | 2022-01-03 |