| NPI | 1528568557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MD LC11219) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-02-16 |
| Last Update Date | 2022-03-25 |