| 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 |