NPI | 1366970626 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL IMT3460) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
106S00000X Behavior Technician | |
Enumeration Date | 2017-05-31 |
Last Update Date | 2022-07-21 |