| NPI | 1457997447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2023-09-05 |