| NPI | 1598064917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 4458) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NC C-11-4041) |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| 171000000X Military Health Care Provider | |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2023-03-31 |