NPI | 1225363898 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 13066) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-07-3871) |
Enumeration Date | 2009-10-14 |
Last Update Date | 2022-01-07 |