| NPI | 1164630760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL mh0003991) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL MH3991) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2018-01-11 |