| NPI | 1619368958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY11546) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH16356) |
| 103K00000X Behavior Analyst (Licence: FL 0-14-6259) | |
| Enumeration Date | 2015-02-09 |
| Last Update Date | 2023-08-24 |