| NPI | 1083173546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-03-14 |
| Last Update Date | 2021-11-09 |