| NPI | 1033404876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OK 5028) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 1067) |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2019-06-11 |