| NPI | 1518597525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101Y00000X Counselor |
| 106H00000X Marriage & Family Therapist | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2020-01-17 |
| Last Update Date | 2023-03-01 |