| NPI | 1487096012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MO 2015044940) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: IL 180009917) |
| 103K00000X Behavior Analyst (Licence: IA 11517918) | |
| 104100000X Social Worker (Licence: IA 008326) | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2020-05-12 |