NPI | 1205245354 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL IMH27131) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-03-1195) |
Enumeration Date | 2014-08-02 |
Last Update Date | 2025-01-23 |