| NPI | 1548569577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH17001) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL MH17001) |
| 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: FL SI1861) | |
| Enumeration Date | 2011-03-16 |
| Last Update Date | 2019-06-06 |