NPI | 1922305093 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: MA 9026) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MA 1-07-3780) |
103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: MA 9026) | |
Enumeration Date | 2011-02-24 |
Last Update Date | 2022-04-15 |