| NPI | 1578994570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361005723) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301015712) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2022-08-04 |