| NPI | 1104472703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: LA PLC9618) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: LA 009481558) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2019-08-11 |
| Last Update Date | 2023-07-21 |