| NPI | 1295506608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KS 05146-T) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: KS RBT-21-170839) |
| Enumeration Date | 2024-01-15 |
| Last Update Date | 2025-11-18 |