| NPI | 1104340256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 106H00000X Marriage & Family Therapist | |
| 106S00000X Behavior Technician | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2017-07-31 |