NPI | 1104590108 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: WA CG61305058) |
Additional Taxonomies | 104100000X Social Worker (Licence: WA SC61519754) |
106S00000X Behavior Technician | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-08-03 |
Last Update Date | 2024-03-13 |