| NPI | 1831503762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY PERMIT # P91577) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2014-06-18 |