| NPI | 1417588039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA APC008832) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2020-02-01 |
| Last Update Date | 2023-01-09 |