| NPI | 1104111640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-12-10380) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH 11537) |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2015-07-13 |