| NPI | 1962777987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 1-15-17993) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC008776) |
| 103K00000X Behavior Analyst (Licence: AL 2018-017) | |
| Enumeration Date | 2012-03-09 |
| Last Update Date | 2019-03-21 |