| NPI | 1306410246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AK 217581) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 101YM0800X Counselor Mental Health (Licence: MO 2025031718) | |
| Enumeration Date | 2021-05-15 |
| Last Update Date | 2025-09-04 |