| NPI | 1376205955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL rbt-20-142361) |
| Enumeration Date | 2021-10-11 |
| Last Update Date | 2026-01-26 |