| NPI | 1386108744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CO LPCC.0021421) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CO RBT-19-76895) |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2023-11-10 |