| NPI | 1891001491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: LA 1225) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: LA L-220) |
| 103T00000X Psychologist (Licence: LA 1225) | |
| Enumeration Date | 2010-08-20 |
| Last Update Date | 2021-05-17 |