| NPI | 1104369313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA 1104369313) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2025-07-16 |