| NPI | 1699177139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MD 05580) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-13-14289) |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2014-09-16 |