| NPI | 1003627290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA APC009921) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: SC 1543540) |
| Enumeration Date | 2025-01-16 |
| Last Update Date | 2026-08-06 |