| NPI | 1811141302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY-10764) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL MH12616) |
| 103K00000X Behavior Analyst (Licence: FL 1-12-11912) | |
| Enumeration Date | 2008-11-10 |
| Last Update Date | 2022-03-03 |