| NPI | 1104472703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 9618) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA PLC9618) |
| 171M00000X Case Manager/Care Coordinator | |
| 106S00000X Behavior Technician (Licence: LA 009481558) | |
| Enumeration Date | 2019-08-11 |
| Last Update Date | 2025-10-29 |