| NPI | 1366174435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA MC61492686) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 101YP2500X Counselor Professional (Licence: TX 92649) | |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2024-01-24 |