| NPI | 1154823409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 23477) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-18-51009) |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2024-01-26 |