| NPI | 1821352055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: PA BH001264) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: PA MF000052) |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2014-04-23 |