| NPI | 1073089884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 6296) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NE 1921) |
| 106S00000X Behavior Technician (Licence: NJ RBT-18-68214) | |
| Enumeration Date | 2018-10-18 |
| Last Update Date | 2025-04-24 |