| NPI | 1306385505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 175T00000X Peer Specialist (Licence: OR THW000000661) | |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2024-04-02 |