| NPI | 1205498060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 253J00000X Foster Care Agency | |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2019-07-02 |