| NPI | 1174909089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: WA RBT-16-17240) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG60535236) |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2017-09-06 |