NPI | 1063060879 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA 1723764) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: GA 1-19-35925) |
225400000X Rehabilitation Practitioner (Licence: GA 586458) | |
Enumeration Date | 2019-08-27 |
Last Update Date | 2023-04-19 |