| NPI | 1528639952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: GA RBT-18-64081) |
| Enumeration Date | 2021-07-07 |
| Last Update Date | 2024-05-03 |