| NPI | 1750723318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301011236) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MI 6301011236) |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2021-04-29 |