| NPI | 1164910642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 114067) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-18-50740) |
| Enumeration Date | 2018-04-30 |
| Last Update Date | 2023-03-17 |