| NPI | 1174278642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK LPCCANDIDATE11852) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: OK RBT-22-203468) |
| Enumeration Date | 2022-02-14 |
| Last Update Date | 2023-12-04 |