| NPI | 1972162733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-19-34540) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NC 5650) |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2021-02-12 |