NPI | 1134609001 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO 00002344) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-18-60130) |
Enumeration Date | 2018-08-20 |
Last Update Date | 2024-03-01 |