| NPI | 1033540653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC23719) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 13962) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2013-12-07 |
| Last Update Date | 2025-08-11 |