| NPI | 1063915072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM CMH0215671) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2021-07-21 |