| NPI | 1932125390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY6075) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH2564) |
| 103K00000X Behavior Analyst (Licence: FL MH2564) | |
| 103T00000X Psychologist (Licence: FL PY6075) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2021-08-06 |