| NPI | 1407350648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM T-CTL0218071) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2022-06-15 |