| NPI | 1285147744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401017721) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-11-07 |
| Last Update Date | 2019-10-21 |