NPI | 1639723620 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6362009599) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: MI RBT-19-93666) |
Enumeration Date | 2019-07-28 |
Last Update Date | 2024-07-15 |