NPI | 1235429093 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC008640) |
Additional Taxonomies | 101Y00000X Counselor |
103K00000X Behavior Analyst | |
Enumeration Date | 2011-04-13 |
Last Update Date | 2021-02-27 |