| NPI | 1205375367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH21838) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-23-68016) |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2023-09-06 |