| NPI | 1104392018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH27043) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-19-82262) |
| Enumeration Date | 2018-10-17 |
| Last Update Date | 2026-01-01 |