| NPI | 1568776912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: CA 3128) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 3128) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA 3128) | |
| 103TC1900X Psychologist, Counseling (Licence: CA 3128) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| 103TS0200X Psychologist, School (Licence: CA 3128) | |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2010-07-27 |