| NPI | 1619372133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities |
| Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2014-10-27 |