| NPI | 1912296724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 021298) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NY 1-04-1604) |
| Enumeration Date | 2011-04-01 |
| Last Update Date | 2021-06-04 |