| NPI | 1023473261 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LA 7902)  | 
| Additional Taxonomies | 103K00000X Behavior Analyst | 
| 222Q00000X Developmental Therapist | |
| Enumeration Date | 2015-12-15 | 
| Last Update Date | 2023-10-10 |