| NPI | 1225661895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR 24-QMHA-R-5654) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-02-21 |
| Last Update Date | 2024-08-07 |