| NPI | 1417699216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: KY RBT-22-211046) |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2023-04-25 |