| NPI | 1477170801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0906013226) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2024-07-22 |