NPI | 1366924243 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WI 10023-125) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: WI 1858833) |
106S00000X Behavior Technician (Licence: WI RBT-18-58833) | |
Enumeration Date | 2018-09-06 |
Last Update Date | 2023-11-16 |