| NPI | 1497298632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0016710) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2016-11-20 |
| Last Update Date | 2020-12-21 |