| NPI | 1164767505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: OR ABAB10174694) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR STB- T-10129963) |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2016-03-07 |