| NPI | 1508192139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 101YP2500X) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VA 101Y00000X) |
| 103K00000X Behavior Analyst (Licence: VA 103K00000X) | |
| Enumeration Date | 2009-11-02 |
| Last Update Date | 2009-11-02 |