| NPI | 1104505254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA APC001854) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2023-07-17 |
| Last Update Date | 2025-12-09 |