NPI | 1205398310 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106S00000X Behavior Technician (Licence: CA 00000000000000000000) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 23754) |
Enumeration Date | 2019-04-05 |
Last Update Date | 2024-05-29 |