| NPI | 1093103194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: PA BH000814) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA BH000814) |
| Enumeration Date | 2014-12-26 |
| Last Update Date | 2014-12-26 |