NPI | 1073381240 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106S00000X Behavior Technician (Licence: VA RBT-23-312959) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0734010418) |
Enumeration Date | 2023-12-18 |
Last Update Date | 2023-12-18 |