| NPI | 1821472242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 2831) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 101YM0800X Counselor, Mental Health (Licence: NE 10578) | |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2018-04-10 |