| NPI | 1124759428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH29144) |
| Enumeration Date | 2022-06-19 |
| Last Update Date | 2026-04-13 |