| NPI | 1912260589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1095670) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 50310) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2015-09-22 |