| NPI | 1306476031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA CG61427270) |
| Additional Taxonomies | 167G00000X Licensed Psychiatric Technician (Licence: CA 2022-080) |
| 106S00000X Behavior Technician (Licence: ID RBT-20-114353) | |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2024-05-29 |