| NPI | 1174201131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6451023216) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2023-07-10 |
| Last Update Date | 2024-01-24 |