| NPI | 1699787374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301015991) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: TX 1810) |
| 103K00000X Behavior Analyst (Licence: MI 7401000585) | |
| 103TC0700X Psychologist Clinical (Licence: TX 23342) | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2020-01-14 |