| NPI | 1518554682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC015372) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-12-23 |
| Last Update Date | 2025-03-14 |