| NPI | 1154090959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: PA PC012837) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: PA PC012837) |
| 101YM0800X Counselor, Mental Health (Licence: PA PC012837) | |
| 106S00000X Behavior Technician (Licence: PA PC012837) | |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2021-09-07 |