| NPI | 1003462060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178.019239) |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2023-08-14 |