| NPI | 1720625965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: IA 1-19-34938) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IA 1-19-34938) |
| Enumeration Date | 2019-12-06 |
| Last Update Date | 2021-06-02 |