| NPI | 1538630090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH16454) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL IMH-15351) |
| Enumeration Date | 2018-12-10 |
| Last Update Date | 2018-12-19 |