| NPI | 1669552501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WV 849) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 103T00000X Psychologist (Licence: WV 849) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2018-08-28 |