| NPI | 1063914869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH24302) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WY PPC-1056) |
| 101YM0800X Counselor, Mental Health (Licence: WY LPC1828) | |
| 103K00000X Behavior Analyst (Licence: FL MH24302) | |
| Enumeration Date | 2018-03-07 |
| Last Update Date | 2025-06-18 |