| NPI | 1083472104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YS0200X Counselor, School | |
| Enumeration Date | 2024-03-12 |
| Last Update Date | 2024-03-12 |