| NPI | 1407692189 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health | 
| Additional Taxonomies | 101Y00000X Counselor | 
| 101YP2500X Counselor, Professional | |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2024-07-02 | 
| Last Update Date | 2024-07-02 |