| NPI | 1881911279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301014390) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MI 11518751) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MI 6301014390) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301014390) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MI 6301014390) | |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2019-01-29 |