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 |