NPI | 1134666894 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-24-75333) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH25341) |
Enumeration Date | 2017-01-19 |
Last Update Date | 2024-08-29 |