| NPI | 1659317162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NC 4306 OTR/L) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 103T00000X Psychologist | |
| 174400000X Specialist (Licence: SC 2890 OT) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2018-02-22 |