| NPI | 1457022295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 10429) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: GA RBT-21-185844) |
| Enumeration Date | 2021-09-22 |
| Last Update Date | 2025-12-08 |