| NPI | 1104211408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-19-37975) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103K00000X Behavior Analyst (Licence: FL MH15591) | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2022-03-11 |