| NPI | 1376196972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC61340812) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2026-07-06 |