| NPI | 1073012944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 20377) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2021-04-28 |