| NPI | 1902354855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: LA 1268) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: LA L-275) |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2018-04-04 |