| NPI | 1356993745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: NV RBT0930) |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2019-11-12 |