| NPI | 1306454855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CT 46.006365) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CT 46.004781) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2023-05-18 |