| NPI | 1063018042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH C.2405760-TRNE) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: OH RBT-20-146935) |
| Enumeration Date | 2020-12-07 |
| Last Update Date | 2024-05-21 |