| NPI | 1215561253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO LPC.0020125) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: KY RBT-19-96765) |
| Enumeration Date | 2020-02-28 |
| Last Update Date | 2023-12-14 |