| NPI | 1114400686 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 136155)  | 
| Additional Taxonomies | 106S00000X Behavior Technician | 
| Enumeration Date | 2018-09-11 | 
| Last Update Date | 2025-07-02 |