| NPI | 1306484126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR 85-1546935) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-12-11 |
| Last Update Date | 2023-10-02 |