| NPI | 1881973170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TN LPC0000004430) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: PA BH001420) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TN 3599) | |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2020-01-15 |