| NPI | 1881940872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: WA 60169605) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: WA 60169605) |
| 103K00000X Behavior Analyst (Licence: AK 626) | |
| 103TC0700X Psychologist Clinical (Licence: WA 60169605) | |
| 103TC0700X Psychologist Clinical (Licence: AK 626) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: AK 626) | |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2012-07-27 |