| NPI | 1073185864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH19055) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MH19055) |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2021-07-12 |
| Last Update Date | 2022-03-17 |