| NPI | 1629272034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301012867) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MI 1-11-9644) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2015-09-21 |