| NPI | 1255900205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: VA RBT-16-19611) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VA 0733003927) |
| Enumeration Date | 2021-06-23 |
| Last Update Date | 2021-06-23 |