| NPI | 1710288717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY11248) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL IMH7514) |
| 103K00000X Behavior Analyst (Licence: FL 1-04-1968) | |
| Enumeration Date | 2010-11-06 |
| Last Update Date | 2024-05-26 |