NPI | 1609121201 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 28857) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-09-5676) |
Enumeration Date | 2012-07-19 |
Last Update Date | 2024-02-27 |