| NPI | 1073057121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM CMH0197871) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2016-12-08 |
| Last Update Date | 2019-04-04 |