| NPI | 1871873059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| 103TR0400X Psychologist, Rehabilitation | |
| Enumeration Date | 2011-08-19 |
| Last Update Date | 2014-04-17 |