| NPI | 1528506441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 098868) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 17116) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-02-11 |
| Last Update Date | 2021-07-06 |