| NPI | 1619049178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: LA 1019) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: LA L-022) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2018-07-24 |