| NPI | 1003215815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: PA PC006114) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-13-14975) |
| Enumeration Date | 2014-08-18 |
| Last Update Date | 2014-08-18 |