| NPI | 1477225670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LGP17298) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: VA 00015484) |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2025-11-21 |