| NPI | 1689218588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 6335) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-11-04 |
| Last Update Date | 2026-08-21 |