| NPI | 1093225500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC A13579) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2018-03-17 |