| NPI | 1740521764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MT SWP-LCSW-LIC-847) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MT BCBA 1-12-11885) |
| Enumeration Date | 2013-03-15 |
| Last Update Date | 2020-02-01 |