| NPI | 1558504159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810004264) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-07-3973) |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2012-08-30 |