| NPI | 1508485095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: GA RBT-19-101259) |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2022-08-02 |