| NPI | 1174079578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH20924) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-17-36731) |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2024-06-06 |