| NPI | 1154930287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OH C.2304950) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2023-03-24 |