| NPI | 1043715261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0704016420) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2024-09-13 |