| NPI | 1639530066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VA 0805002339) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 222Q00000X Developmental Therapist | |
| Enumeration Date | 2016-03-12 |
| Last Update Date | 2024-06-20 |