| NPI | 1356077101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: SC 8270) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2022-07-25 |
| Last Update Date | 2024-03-05 |