NPI | 1780120030 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: NY 024844-01) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: PA BH001579) |
Enumeration Date | 2017-01-10 |
Last Update Date | 2022-03-28 |