| NPI | 1790991073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-15-19086) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301012909) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2016-09-22 |