| NPI | 1124373675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180.011828) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 101YP2500X Counselor, Professional (Licence: IL 180.011828) | |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2024-03-21 |