| NPI | 1770854788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 021154) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NY 000291) |
| 103K00000X Behavior Analyst (Licence: NY 1-08-4553) | |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2019-02-12 |