| NPI | 1629327226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VA 0133000950) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MD LBA432) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6361000361) | |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2022-01-20 |