| NPI | 1609178078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: WI 88-140) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 1796-226) |
| Enumeration Date | 2010-11-17 |
| Last Update Date | 2015-02-04 |