| NPI | 1730453978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY60517719) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: GA 1-11-9001) |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2015-05-19 |