| NPI | 1376077305 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL BACB384055) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| Enumeration Date | 2017-04-17 | 
| Last Update Date | 2022-09-06 |