| NPI | 1215301155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL IMH19480) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2021-08-21 |