| NPI | 1972911295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA 31687) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-11-8657) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-07-30 |
| Last Update Date | 2020-11-15 |