| NPI | 1407302177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH21648) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 101YM0800X Counselor, Mental Health (Licence: FL IMH19698) | |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2023-02-28 |