| NPI | 1871094045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TN 4105) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-02-23 |
| Last Update Date | 2025-12-18 |