| NPI | 1114579240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-26-88896) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 27635) |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2026-04-01 |