| NPI | 1184124224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 2544) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-18-52675) |
| Enumeration Date | 2018-02-15 |
| Last Update Date | 2024-10-15 |