| NPI | 1972758639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: LA 216) |
| Enumeration Date | 2008-11-22 |
| Last Update Date | 2020-09-07 |