| NPI | 1023403920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL MH12394) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH12394) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2022-03-26 |