| NPI | 1184398588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-08-09 |
| Last Update Date | 2022-09-16 |