NPI | 1235860495 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 11786-125) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
106S00000X Behavior Technician | |
Enumeration Date | 2022-06-20 |
Last Update Date | 2025-05-13 |