| NPI | 1366930760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC14912) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2026-02-18 |