| NPI | 1063955490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NM CMH0216281) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2016-12-03 |
| Last Update Date | 2023-05-29 |