| NPI | 1134615289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 4763) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2025-01-14 |