| NPI | 1003481128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701014510) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-05-21 |
| Last Update Date | 2025-05-13 |