| NPI | 1245763879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: 6451018734) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6451018734) |
| 101YM0800X Counselor, Mental Health (Licence: FM 6451018734) | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2022-06-27 |