| NPI | 1134918667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: LA R-15622) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA PLC10919) |
| Enumeration Date | 2025-05-01 |
| Last Update Date | 2026-01-15 |