| NPI | 1245842095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: FL MH24024) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MH24024) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2020-08-21 |
| Last Update Date | 2024-09-27 |