| NPI | 1053955542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPCC.0021557) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: TX 28749429) |
| Enumeration Date | 2019-10-29 |
| Last Update Date | 2024-01-23 |