| NPI | 1063087104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH CDCA.184467) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: QMHS) |
| Enumeration Date | 2021-05-21 |
| Last Update Date | 2023-10-30 |