| NPI | 1629513510 |
|---|---|
| Former Name | ANGIE BOLANOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TS0200X Psychologist, School |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-16-24325) |
| Enumeration Date | 2016-12-30 |
| Last Update Date | 2025-02-12 |