| NPI | 1194153536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH18971) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: WI 21120-875) |
| 103K00000X Behavior Analyst (Licence: FL 1-18-31957) | |
| Enumeration Date | 2013-10-22 |
| Last Update Date | 2022-06-20 |