NPI | 1447926621 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL IMH26192) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-19-104102) |
Enumeration Date | 2021-08-18 |
Last Update Date | 2024-07-25 |