| NPI | 1063915718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 138219) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA 17-43275) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-08 |
| Last Update Date | 2025-02-06 |