| NPI | 1144945551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2022-10-07 |
| Last Update Date | 2024-08-14 |