| NPI | 1225758410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 14748) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: NE RBT-22-231961) |
| Enumeration Date | 2022-08-30 |
| Last Update Date | 2026-01-12 |