| NPI | 1013289990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC007217) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401015788) |
| 106S00000X Behavior Technician | |
| 101YM0800X Counselor, Mental Health (Licence: GA APC002573) | |
| Enumeration Date | 2012-02-07 |
| Last Update Date | 2018-08-17 |