| NPI | 1295408540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA 615999687) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: HI 21-156423) |
| Enumeration Date | 2021-07-30 |
| Last Update Date | 2024-11-25 |