| NPI | 1154066009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-22494) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2022-05-04 |
| Last Update Date | 2023-09-25 |