| NPI | 1831490788 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY 60260580)  | 
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-07-3421)  | 
| Enumeration Date | 2010-11-09 | 
| Last Update Date | 2012-08-07 |