| NPI | 1366039893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2023018352) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-12-30 |
| Last Update Date | 2023-06-13 |