| NPI | 1760990592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 32213) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-16-27302) |
| Enumeration Date | 2018-01-15 |
| Last Update Date | 2020-12-03 |