| NPI | 1023578093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A17798) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2022-08-04 |