NPI | 1629216940 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY 16494) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA BCBA# 1-08-4657) |
Enumeration Date | 2009-01-23 |
Last Update Date | 2015-08-27 |