| NPI | 1003649641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: NV intern) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TN intern) |
| Enumeration Date | 2024-08-20 |
| Last Update Date | 2024-08-20 |