| NPI | 1356039242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA 61578014) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: WA 60769267) |
| Enumeration Date | 2023-04-27 |
| Last Update Date | 2024-10-10 |