| NPI | 1073185864 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-24-76451) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH19055) | 
| 101Y00000X Counselor (Licence: MH19055) | |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2021-07-12 | 
| Last Update Date | 2025-02-24 |