| NPI | 1023765948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL BACB427293) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 28691) |
| Enumeration Date | 2022-03-10 |
| Last Update Date | 2026-10-06 |