| NPI | 1376014506 |
|---|---|
| Former Name | MARYCILENE RAFTERY RAMIREZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2018-12-16 |