| NPI | 1134832694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: MD 32632) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0903003146) |
| Enumeration Date | 2022-12-29 |
| Last Update Date | 2025-01-08 |