| NPI | 1265925440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LPC.0020764) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 0019483) |
| 106S00000X Behavior Technician (Licence: RBT-18-57793) | |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2024-06-09 |