| NPI | 1366796708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 11212210) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH24984) |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2025-03-10 |