| NPI | 1396211892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC A17396) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-10-23 |
| Last Update Date | 2022-06-07 |