| NPI | 1366174435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC61492686) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 92649) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2025-08-26 |