| NPI | 1881944791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 879-58) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: WI 1-12-11508) |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2012-09-18 |