| NPI | 1174161442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH C2002714) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: OH RBT-18-63430) |
| 101YM0800X Counselor, Mental Health (Licence: OH C.2103794) | |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2021-10-04 |