| NPI | 1215646393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 106S00000X Behavior Technician (Licence: GA RBT-22-244739) | |
| Enumeration Date | 2022-11-17 |
| Last Update Date | 2026-01-19 |