NPI | 1649634163 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-15-21213) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 40567) |
Enumeration Date | 2016-04-11 |
Last Update Date | 2016-04-11 |