| NPI | 1942421342 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-21-54264) | 
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: FL SS679) | 
| 101YM0800X Counselor, Mental Health (Licence: FL MH7915) | |
| Enumeration Date | 2007-05-01 | 
| Last Update Date | 2025-07-14 |